Background: The aim of this study was to identify characteristics of pregnant women with obesity that contribute to increased cesarean rate.
Methods: Retrospective cohort in a single academic institution between 2012 and 2019. Women who delivered during this period were classified according to the Robson classification. Women with normal body mass index (N=11797) and with obesity (N=2991) were compared. The contribution of each Robson group to the overall caesarean rate were compared.
Results: The overall cesarean rate was higher for women with (28.1%) than without (14.2%, p < 0.001) obesity. This result came mainly from Robson group 5a (history of one cesarean). After adjustment for medical factors within this group, the association between maternal obesity and cesarean during labor was significant.
Conclusions: The higher cesarean rate in women with obesity is explained by Robson group 5a in which obesity is an independent risk factor of in labor cesarean delivery.

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On 08 Nov, 2020
Received 29 Oct, 2020
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On 28 Oct, 2020
Received 28 Oct, 2020
On 27 Oct, 2020
On 23 Oct, 2020
Invitations sent on 23 Oct, 2020
On 23 Oct, 2020
On 22 Oct, 2020
On 22 Oct, 2020
Posted 01 Sep, 2020
Received 21 Sep, 2020
On 21 Sep, 2020
Received 19 Sep, 2020
Received 11 Sep, 2020
On 31 Aug, 2020
On 29 Aug, 2020
On 29 Aug, 2020
Received 29 Aug, 2020
On 27 Aug, 2020
On 26 Aug, 2020
Invitations sent on 26 Aug, 2020
On 25 Aug, 2020
On 25 Aug, 2020
On 08 Nov, 2020
Received 29 Oct, 2020
Received 29 Oct, 2020
On 28 Oct, 2020
Received 28 Oct, 2020
On 27 Oct, 2020
On 23 Oct, 2020
Invitations sent on 23 Oct, 2020
On 23 Oct, 2020
On 22 Oct, 2020
On 22 Oct, 2020
Posted 01 Sep, 2020
Received 21 Sep, 2020
On 21 Sep, 2020
Received 19 Sep, 2020
Received 11 Sep, 2020
On 31 Aug, 2020
On 29 Aug, 2020
On 29 Aug, 2020
Received 29 Aug, 2020
On 27 Aug, 2020
On 26 Aug, 2020
Invitations sent on 26 Aug, 2020
On 25 Aug, 2020
On 25 Aug, 2020
Background: The aim of this study was to identify characteristics of pregnant women with obesity that contribute to increased cesarean rate.
Methods: Retrospective cohort in a single academic institution between 2012 and 2019. Women who delivered during this period were classified according to the Robson classification. Women with normal body mass index (N=11797) and with obesity (N=2991) were compared. The contribution of each Robson group to the overall caesarean rate were compared.
Results: The overall cesarean rate was higher for women with (28.1%) than without (14.2%, p < 0.001) obesity. This result came mainly from Robson group 5a (history of one cesarean). After adjustment for medical factors within this group, the association between maternal obesity and cesarean during labor was significant.
Conclusions: The higher cesarean rate in women with obesity is explained by Robson group 5a in which obesity is an independent risk factor of in labor cesarean delivery.

Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
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